2014-2015 MSW Fellows in Aging

Leadership Projects

Background: The Francis E. Parker Memorial Home is a not-for-profit organization that offers a wide array of long term care services including skilled nursing, memory care, assisted living residences, as well as adult day services and health and wellness community services for older adults in Central New Jersey. In 1998 Parker Home became one of four registered Eden Alternative™ homes in the state of New Jersey. Parker Home began a culture change journey at the time to ensure greater involvement and stronger communication among the care team and to continue to strengthen its person-centered environment. In 2014, a Culture Team was created to further develop Parker Home’s cultural identity to make it more portable as the organization continues to grow; enable Eden culture to be more successful; and measure success in culture implementation and change. Parker Home hopes to create a unique identity apart from the Eden Alternative through this process.

Project Aim: As a contribution to the Culture Team’s Education task force, I completed a qualitative study examining the knowledge and perceptions of organizational culture among employees. Fifteen face-to face interviews were conducted with staff across different departments on two campuses, with particular attention to how the organization can improve its education and training opportunities around organizational culture.

Outcomes: The end product of this project was a S.W.O.T. (Strengths, Weaknesses, Opportunities and Threats) analysis of Parker’s present culture and educational practices. With this, I identified key points and recommendations for the task force to consider concerning strategies for culture education as Parker continues on the Eden Alternative Path to Mastery, seeks to identify its organizational culture as a unique way of caring for elders, and expands in the future.

Reflections: This project has allowed me to critically evaluate how to improve an organization’s functioning and to practice communicating research results to health professionals. Organizational culture within long-term care communities significantly contributes to the quality of care provided. As a social work leader in the field of aging, I will take the knowledge I have gained from this project to advocate for both care-providers and those that they care for to promote environments that allow for the best work environments and care.

GABRIELA NIEVES-MOSKONAS

Leadership Project: Enhancing the Engagement of Outreach Volunteers at the AARP NJ State Office

Background: AARP is a national nonprofit organization that champions issues that matter to the 50+ age group, such as healthcare, employment security, and retirement planning. As part of this work, AARP provides older adults the opportunity to contribute as volunteers through community outreach concerning AARP’s position on issues confronting older adults. Volunteers attend events, such as health fairs, senior fairs, and informational conferences. AARP NJ’s Outreach Unit aimed to enhance their volunteer management strategies with an eye toward expanding outreach volunteers in the future.

Project Aim: As a member of the Outreach Unit, I began to explore ways in which I could combine findings from research on older adult volunteers with quantitative surveys that could be done with both current and former volunteers. Moreover, AARP wanted to expand its penetration into more counties by recruiting more volunteers. To that end, this project aimed to learn what percentage of 121 volunteers from an initial list remained interested in volunteering and how AARP could engage a greater percentage of the volunteers on the list. Mail-back surveys were administered to the 121 volunteers to assess current and future levels of engagement, identify possible barriers to engagement, grow the volunteer list, and identify preferences around training.

Outcomes: Results from the survey indicated that the number of available outreach volunteers has declined significantly within recent years and that many counties in New Jersey do not currently have any outreach volunteers. Common barriers to participation included health problems and issues concerning transportation, which are expected to become even greater barriers to participation as the volunteer pool advances in age. Guided by national research on volunteerism in later life, I delineated several recommendations that AARP NJ could consider in expanding its outreach volunteer program as well as increase its retention of current volunteers, including the designation of a volunteer manager.

Reflections: I was able to learn first-hand the importance of research for addressing issues within any organization. I learned how crucial it is to design a survey instrument to make sure it will measure exactly what you are trying to measure. Overall, this project demonstrated the value of spending resources on research that can create change, affect policy, and ultimately save resources in the future.

Background: The Carol G. Simon Cancer Center (CGSCC) at Morristown Medical Center offers various psychosocial support services to cancer patients and their families during and after treatment. The Social Work Department works with patients and their families in many critical areas, such as: dealing with fear and anxiety related to the cancer diagnosis and treatment; assisting with financial concerns, work-related issues and home care needs; planning for life post-treatment; and bereavement.

Project Aim: The leadership project sought to bolster a current CGSCC initiative to better understand caregiver needs. Specifically, the goal was to strengthen the Center’s approach by: (a) analyzing data collected through a survey of caregivers at CGSCC; (b) conducting a thorough literature review of cutting-edge, evidence-based interventions used in cancer settings; (c) practicing these interventions with caregivers and developing a personal understanding of their needs; and (d) presenting a report that included four SMART goals (Specific, Measurable, Attainable, Realistic and Timely) for the CGSCC to consider in its future work with caregivers.

Outcomes: National research supports that caregivers are as overlooked as they are important in cancer care. They provide more than half the care needed by patients, yet they often assume the caregiving role by default with no formal training and little understanding of the knowledge, resources, and skills that their role demands. To provide high-quality to care recipients, caregivers need professionals who understand their value and empower them towards optimal engagement. Although there is no one-size-fits-all model for intervening with caregivers, an analysis of existing research distilled three categories of superior evidence-based interventions: psycho-education, skills training, and therapeutic counseling.

Reflections: It was an honor and a privilege to work with caregivers in the cancer setting. The fellowship project provided me the opportunity to delve deeper into the field education experience as I considered how caregivers fit into the big picture and asked the question of how to best support them. Now is an opportune time for systematic efforts to support caregivers, as leading health system CEOs are calling for better integration of caregivers to benefit both quality of care and the bottom line.

Background: LIFE at Lourdes (LIFE), a Program of All-Inclusive Care for the Elderly (PACE) in Pennsauken Township, is a day program for older adults that provides services such as transportation, medical care, rehabilitation therapy, mental health care, personal care, recreation, meals, and home care. The goal of PACE programs is to allow older adults at high risk for institutionalization to live safely in their own homes for as long as they so choose. Older adults with depression may have decreased functional status, sleep disorders, decreased treatment compliance, higher rate of falls and lower perceived quality of life. Decreasing depression in older adults can therefore have a beneficial impact on their well-being and the cost of treatment within the PACE program.

Project Goals: The purpose of this project was to identify ways to bolster mental health services, specifically counseling, for LIFE participants experiencing high levels of depressive symptoms. It involved conducting interviews with participants and mental health professionals on staff to determine why participants are, or are not, utilizing counseling services within the social work department. It also used administrative data to identify potential sub-groups of older adults in the program who are more inclined to have depressive symptoms and why, if at all, any particular groups are less inclined to seek or accept mental health services.

Outcomes: According to the administrative data, there was no particular group of participants more likely to have depression. Interviews with social workers indicated that the high amount of case management (in part, due to the especially low socioeconomic status of the participants), the lack of a scheduling system, and the participants’ busy schedules at the day program made it difficult to provide adequate counseling services. Participant surveys indicated they did not always remember counseling services were available. Recommendations were summarized and presented to the LIFE administration and management team.

Reflections: At LIFE, social workers wanted to be able to provide more effective mental health care, and participants wanted to receive mental health care. As demonstrated by their positive response to my final presentation and willingness to address the suggested recommendations, it was clear that the administration was receptive to improving mental health, but they had not been aware of the need for improved services and what could be done to make them possible. Overall I have learned how to properly evaluate mental health care needs through research and effective interviewing skills. As a leader in social work, I can carry forward the importance of effective communication among participants, staff, and administration to ensure that the best possible services are being provided.